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References Menopause. National Institute on Aging. Accessed April 24, Casper RF, et al. Clinical manifestations and diagnosis of menopause. Longo DL, et al. Menopause and postmenopausal hormone therapy. In: Harrison's Principles of Internal Medicine. New York, N. Nelson LM, et al.
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Menopausal hot flashes. Martin KA, et al. Menopausal hormone therapy: Benefits and risks.
Yoga, Kegel exercises, pelvic floor physical therapy. The North American Menopause Society. Accessed April 23, North American Menopause Society.
MenoNote: Vaginal dryness. Welt CK, et al. Pathogenesis and causes of spontaneous primary ovarian insufficiency premature ovarian failure. Ovarian development and failure menopause in normal women. Frequently asked questions. Women's health FAQ The Menopause Years. American College of Obstetricians and Gynecologists.
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Clinical manifestations, diagnosis, and evaluation of osteoporosis in post-menopausal women. Natural Medicines. Accessed April 27, Dodin S, et al. Acupuncture for menopausal hot flushes. Cochrane Database of Systematic Reviews. Laughlin-Tommaso SK expert opinion.
Medical Decisions, Estrogen and Aging [Jay Schulkin] on giuliettasprint.konfer.eu *FREE* shipping on qualifying offers. The decision making process that underlies. Compre o livro Medical Decisions, Estrogen and Aging na giuliettasprint.konfer.eu: confira as ofertas para livros em inglês e importados.
Mayo Clinic, Rochester, Minn. May 9, Bachmann G, et al. Treatment of genitourinary syndrome of menopause vulvovaginal atrophy.
Accessed May 10, Home use tests: Menopause. Food and Drug Administration. Accessed July 18, If the address matches an existing account you will receive an email with instructions to retrieve your username. Search for more papers by this author. Hormone replacement therapy HRT has been proposed for the prevention and treatment of many chronic conditions, ranging from osteoporosis, heart disease, urinary incontinence, and Alzheimer's disease.
With the exception of osteoporosis, however, many of the suggested benefits remain controversial. Part of the controversy stems from the relative absence of randomized controlled trials, particularly those enrolling sufficient numbers of elderly women. We propose that another factor may also contribute, one that has been overlooked - failure to consider the variable endogenous estrogen status of elderly women.
Highly variable levels of estrogens are present in nearly all postmenopausal women, even at advanced ages. Similar to other endocrine systems, estrogen deficiency and the need for its replacement are, therefore, likely to be relative rather than absolute. Because many markers of estrogen deficiency exhibit overlap between risk groups, their clinical usefulness as predictors of frailty, disability, and response to HRT has been limited.
Future studies will need to focus not only on the use of highly variable circulating serum estrogen levels but also on markers of overall estrogenic effects at the level of individual target tissues i. We propose that a clinical approach that takes into consideration the remarkable heterogeneity physiological as well as psychological of elderly women will enable us to approach the decision about HRT in a more individualized and possibly better targeted fashion.
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